Activities of daily living (ADL) have been suggested for the evaluation of hand function (Sollerman, C., & Sperling, L. (1978). Evaluation of Activities of Daily Living Function—Especially Hand Function. Scandinavian Journal of Rehabilitative Medicine. Vol. 6, 139-43, which is hereby incorporated by reference). In particular the Sollerman test has been suggested for patients undergoing long term haemodialysis (Limaye, V., Frankham, A., Disney, A., & Pile, K. (2001). Evaluation of Hand Function in Patients Undergoing Long Term Haemodialysis. Annals of the Rheumatic Diseases. Vol. 60, Part 3, 278-80, which is hereby incorporated by reference). However, clinical assessments like Sollerman require subjective ratings, which are time consuming and difficult to standardize.
The ability to objectively and effectively assess hand function is of great importance for clinicians in many medical and surgical specialties. Various measurement tools are subsequently used in research studies and routine practice. However, none is specifically built for the evaluation of dynamic hand function events such as those required in activities of daily living (ADL) like eating, opening a jar, closing a zipper, etc. Vascular Surgeons create access to dialysis for chronic kidney disease patients in their arms. This has been preferentially done in the non-dominant arms, partially due to concerns about adverse effects of the surgery on hand function in ADL. The available tools to evaluate hand function after surgery are unfortunately limited and inadequate for comprehensive measurements.
Patients undergoing kidney dialysis often suffer loss of hand function in the arm of access. Current metrics for assessing this loss are time consuming even for a skilled administrator. Furthermore, the impact on activities of daily living (i.e. opening or closing a jar, buttoning or zipping clothing) is poorly reflected in the assessment score. Vascular surgeons usually choose the non-dominant arm for an access site. However, the non-dominant arm is often not the best anatomical choice
In one example study, out of 23 end-stage renal patients identified with finger gangrene, 12 (52%) necessitated repeat finger amputations, and 14 (61%) developed bilateral finger gangrene. Over 1,000,000 U.S. workers receive treatment in emergency departments for acute hand injuries annually. Surgery for Carpal Tunnel Syndrome (CTS) has been reported as the second most common type of surgery, with more than 230,000 procedures performed every year. Up to 30% of all CTS patients require unlimited medical care. Apart from finger gangrene in ESRD patients with AVF, acute hand injuries, and CTS, various neurological and rheumatological conditions also account for hand impairment or disability.